The broad objective of the proposed project is to enhance the measurement of client self-reported clinical and functional mental health status among diverse mental health and substance abuse service recipients. Efforts to stem the rising costs of mental health and substance abuse services have highlighted the importance of assessing clinical outcomes. The 32-item Behavior and Symptom Identification Scale (BASIS-32) is an instrument designed specifically for outcome assessment. However, it was developed on a homogeneous population of inpatients at one site. To be useful on a national level a measure needs to be tested and validated on more diverse samples and at multiple sites. The proposed research will use qualitative (readability analysis, cognitive testing procedures), and quantitative methods (psychometric testing and Item Response Theory modeling), to refine,, field test and validate an improved and more widely applicable outcome assessment instrument. In addition, the research will develop and implement a methodology for creating risk-adjusted outcome benchmarks. This work will be accomplished by sampling treated clients from inpatient (N=6,000) mental health and substance abuse service delivery sites in each of the four US census regions. Data analysis will include assessment of representativeness of sites and clients, data quality, factor structure/ subscale composition, reliability, validity, and sensitivity to change over time. Assessment of the instrument's psychometric properties will be based on concepts from both Classical Test Theory and Item Response theory. Hierarchical modeling will be used to create risk-adjusted outcome benchmarks.